Australian Trachoma Surveillance Report 2012

Western Australia Results 2012

Trachoma screening and management data for 2012 were provided to the National Trachoma Surveillance and Reporting Unit by the Northern Territory (NT), South Australia (SA), Western Australia (WA) and Queensland (Qld). Data were analysed by region in the NT, SA and WA, with five regions in the NT, four in SA and four in WA. Queensland screened six communities and its data was aggregated for analysis. Jurisdictional authorities had designated 204 remote Aboriginal communities as being at risk of endemic trachoma in 2012.

Page last updated: 23 December 2013

Screening coverage

  • At-risk community coverage of trachoma screening in the four regions with endemic trachoma in WA was 99%, with 77 out of 78 at-risk communities screened for trachoma (Table 4.1).
  • An increase of the number of communities screened was observed in the Goldfields region since 2011. However in 2011, 10 communities in this region were amalgamated into one distinct community for the purpose of presenting data in this report (Figure 4.2).
  • The number of communities screened across Kimberley and Midwest regions was constant between 2011 and 2012 (Figure 4.2).
  • The proportion of children aged 5-9 years screened in at-risk regions was 73% (range 63 - 82%) (Table 4.1, Figure 4.3).
  • A substantial increase in trachoma screening among 5-9 year of children was observed in all regions since 2011 and since screening data collection began in 2007 (Figure 4.3).

Clean face prevalence

  • The overall prevalence of clean faces among 5-9-year-old children screened in WA was 81%. The highest rate was found in the Pilbara region (94%) (Table 4.1, Figure 4.4).

Trachoma prevalence

  • The prevalence of trachoma among children aged 5-9 years who were screened in WA was 4%. Prevalence ranged from 2% to 10% (Table 4.1).
  • No active trachoma was detected in 61% (46/75) (Figure 4.6) of communities screened that screened children aged 5-9 years, an increase from 58% (40/69) in 2011.
  • A decreasing trend continues in the percentage of communities with trachoma prevalence greater than 5% (Figure 1.8), from 60% in 2009, to 50% in 2010, to 36% in 2011 and 29% in 2012.
  • Compared to 2011, trachoma prevalence in all regions in WA decreased in 2012 (Figure 4.5).
  • The highest prevalence of trachoma among children 5-9 years was 54% within a community in the Kimberley region where less than 20 children were screened.

Treatment coverage

  • Treatment for trachoma was required for 35 of the 77 screened at-risk communities (Table 4.2).
  • Of the active cases of trachoma detected at screening, 93% were treated with azithromycin (Table 4.2).
  • Azithromycin was used to treat the estimated 93% of the population requiring treatment, however population data were not provided for six communities that treated active cases only (Table 4.2).
  • Of the 35 communities requiring treatment, 26 received treatment according to CDNA guidelines (Table 4.2).

Trichiasis

  • Trichiasis screening was undertaken in all regions of WA, with 52% (2,129/4,130) of the estimated at-risk population screened (Table 4.3).
  • Trichiasis was detected in 1% (22/2,129) of adults screened (Table 4.3).
  • Nine cases of trichiasis were reported to have received surgery in the last 12 months (Table 4.3).

Health promotion

  • Health promotion activities were reported in 93% (73/78) of at-risk communities, with an overall 263 health
  • promotions initiatives reported (Table 4.4).
  • Of the initiatives reported, 42% (110/263) were directed toward children and 28% (74/263) used an interactive group session method.
  • Of the initiatives reported, 70% (183/263) reported delivering these programs 2-4 times in the year, and 10% (26/263) reported these programs were a routine and ongoing initiative within at-risk communities.
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Figure 4.1 Trachoma prevalence in children aged 5‑9 years, number of communities screened and number of communities at‑risk in 2012 in Western Australia


Map of Western Australia, with shaded legend distinguishing the trachoma prevalence in 2012. Kimberley 31 out of 31 at-risk communities screened showing 2% trachoma prevalence. Pilbara, 15 out of 15 at-risk communities screened showing 3% trachoma prevalence. Midwest, 8 at-risk communities screened showing 4% trachoma prevalence. Goldfields, 23 out of 24 at-risk communities screened showing 10% trachoma prevalence.


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Figure 4.2 Number of communities screened* by year and region in Western Australia, 2007 – 2012


Line graph shows trends by WA regions (Goldfields, Kimberley, Midwest and Pilbara).
The trend over time was generally stable in the Kimberley (hovering around the 30s), Midwest (hovering between 5 & 9) and Pilbara (hovering around 15). The Goldfields region had an increasing trend from 2007 – 2009, a slight decreasing trend for 2010 & 2011 and an increase in 2012 (approx. 7 to 24).

* Including communities screened but not at risk
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Figure 4.3 Population screening coverage* of children aged 5‑9 years over all regions containing at least one at‑risk community by year and region in Western Australia, 2007 – 2012


Line graph shows trends by WA regions (Goldfields, Kimberley, Midwest and Pilbara).Generally the trend for all regions was relatively stable from 2007 to 2011 (hovering around 35% for Goldfields, 55% in Kimberley, 15% in Midwest and 30% in Pilbara) and then significantly increased in 2012 (to approx. 65-80%).

* Including children in communities screened but not at risk
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Figure 4.4 Proportion of screened children* aged 5‑9 years who had a clean face by year and region in Western Australia, 2007 – 2012


Line graph shows trends by WA regions (Goldfields, Kimberley, Midwest and Pilbara).Generally the trend for regions across years was stable, hovering around 80%.  The Goldfields had a decreasing trend from 98% in 2007 to 50% in 2011 and then increasing to 77% in 2012.

* Including children in communities screened but not at risk
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Figure 4.5 Trachoma prevalence among screened* children aged 5‑9 years by year and region inWestern Australia, 2007 – 2012


Line graph shows trends by WA regions (Goldfields, Kimberley, Midwest and Pilbara).The trend in the Goldfields region increased from 3% in 2007, peaked at14% in 2009, and decreased to 11% in 2011 and 10% in 2012. The Kimberley has a gradual decreasing trend from 17% in 2007 to 2% in 2012. The trend for the Midwest was inconsistent with a prevalence of 20% in 2007, dipping to 14% in 2008, increasing to 17% in 2009, dipping to 7% in 2010, increasing to 9% in 2011, and decreasing to 4% in 2012.  The trend in the Pilbara peaked at 26% in 2008 and decreased from that time to 3% in 2012

* Including children in communities screened but not at risk
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Figure 4.6 Trachoma prevalence among children aged 5‑9 years in screened at‑risk communities in 2012 by region in Western Australia


Histogram shows trends by WA regions (Goldfields, Kimberley, Midwest and Pilbara). For the Goldfields’ communities screened approx. 45% had no trachoma, 10% had >0% but <5%, 18% had > or equal to 5% but <10%, 5% had > or equal to 10% but <20%, and 22% > or equal to 20%. For the Kimberley’s communities screened approx. 68% had no trachoma, 13% had >0% but <5%, 10% had > or equal to 5% but <10%, 3% had > or equal to 10% but <20%, and 6% > or equal to 20%. For the Midwest’s communities screened approx. 63% had no trachoma, 0% had >0% but <5%, 25% had > or equal to 5% but <10%, 12% had > or equal to 10% but <20%, and 0% > or equal to 20%. For the Pilbara’s communities screened 71% had no trachoma, 7% had >0% but <5%, 7% had > or equal to 5% but <10%, 0% had > or equal to 10% but <20%, and 15% > or equal to 20%.

* One community in both Goldfields and Pilbara did not screen children in the 5‑9 year age group
† Number of communities
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Figure 4.7 Trachoma prevalence of 5‑9 year old children in screened at‑risk communities in 2012 by sex and region in Western Australia


Column graph by WA regions (Goldfields, Kimberley, Midwest and Pilbara).The Goldfields and Midwest regions had greater trachoma prevalence in boys than girls and the Kimberley and Pilbara regions had slightly higher trachoma prevalence in girls than boys.  Overall, for WA trachoma prevalence was higher in boys than girls. Data for each region: Goldfields  recorded 6.7% for girls and 8.4% for boys. Kimberley recorded 2.7% for girls and 2% for boys. Midwest recorded 3.6% for girls and 4.2% for boys. Pilbara recorded 2.8% for girls and 2.7% for boys and WA total record was 3.10% for girls and 3.9% for boys.

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Table 4.1 Trachoma screening coverage, trachoma prevalence, and clean face prevalence in Western Australia in 2012 by region

* Calculated as the proportions of children with active trachoma in age groups 1-4 and 5-9 years, weighted by the estimated population sizes of each age group. This calculation accounts for uneven coverage with respect to age groups

Goldfields Kimberley Midwest Pilbara Total
Number of communities at risk 24 31 8 15 78
Number of communities screened 23 31 8 15 77
Trachoma prevalence 1-9 years (weighted by population)* 8% 2% 4% 2% 3%
Age group (years) 1-4 5-9 10-14 1-14 1-4 5-9 10-14 1-14 1-4 5-9 10-14 1-14 1-4 5-9 10-14 1-14 1-4 5-9 10-14 1-14
ABS estimated number of Aboriginal children at risk 586 567 540 1693 898 1027 896 2821 115 128 140 383 366 375 320 1061 1965 2097 1896 5958
Jurisdiction Estimated number of Aboriginal children at risk 151 448 361 960 204 1379 622 2205 53 210 183 446 116 269 221 606 524 2306 1387 4217
Children examined for clean face 60 365 221 646 96 992 260 1348 20 132 131 283 78 220 199 497 254 1709 811 2774
Children with clean face 35 281 197 513 67 804 237 1108 14 88 87 189 63 206 192 461 179 1379 713 2271
Clean face prevalence 58% 77% 89% 79% 70% 81% 91% 82% 70% 67% 66% 67% 81% 94% 96% 93% 70% 81% 88% 82%
Children examined for trachoma 60 365 221 646 86 972 242 1300 20 132 131 283 78 220 199 497 244 1689 793 2726
Trachoma screening coverage 40% 81% 61% 67% 42% 70% 39% 59% 38% 63% 72% 63% 67% 82% 90% 82% 47% 73% 57% 65%
Children with active trachoma 3 37 22 62 1 23 5 29 1 5 4 10 1 6 3 10 6 71 34 111
Active trachoma prevalence 5% 10% 10% 10% 1% 2% 2% 2% 5% 4% 3% 4% 1% 3% 2% 2% 2% 4% 4% 4%
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Table 4.2 Treatment coverage in Western Australia in 2012 by region

* Communicable Diseases Network Australia. Guidelines for the public health management of trachoma in Australia. March 2006

† Three communities in both Goldfield and Midwest regions did not provide estimates for contacts requiring treatment, and active cases only were treated

Goldfields Kimberley Midwest Pilbara Total
Number of communities at risk 24 31 8 15 78
Number of communities screened 23 31 8 15 77
Number of communities requiring treatment 15 11 4 5 35
Number of communities treated according to CDNA guidelines* 10 11 0 5 26
Age group (years) 0-4 5-9 10-14 15+ All 0-4 5-10 10-15 15+ All 0-4 5-9 10-14 15+ All 0-4 5-9 10-14 15+ All 0-4 5-9 10-14 15+ All
Active cases requiring treatment 3 37 22 62 1 23 5 29 1 5 4 10 1 6 3 10 6 71 34 111
Active cases received treatment 3 36 19 58 1 22 3 26 1 4 4 9 1 6 3 10 6 68 29 103
% Active cases received treatment 100% 97% 86% 94% 100% 96% 60% 90% 100% 80% 100% 90% 100% 100% 100% 100% 100% 96% 85% 93%
Estimated contacts requiring treatment (according to jurisdictional interpretation of the guidelines) 22 28 14 103 167 62 93 75 172 393 0 3 4 0 7 7 11 19 26 63 91 135 112 301 639
Number of contacts who received treatment† 21 28 14 98 161 58 87 69 166 372 0 0 1 0 1 7 11 19 26 63 75 126 103 290 594
% Estimated contacts received treatment† 95% 100% 100% 95% 96% 94% 94% 92% 97% 95% 0% 25% 14% 100% 100% 100% 100% 100% 82% 93% 92% 96% 93%
Estimated overall treatment coverage (total)† 96% 98% 92% 95% 96% 94% 94% 90% 97% 94% 100% 50% 63% 59% 100% 100% 100% 100% 100% 84% 94% 90% 96% 93%
Table 4.3 Trichiasis screening coverage, prevalence and treatment among Aboriginal adults aged over 40 years in 2012 in Western Australia
Goldfields Kimberley Midwest Pilbara Total
Number of communities at risk 24 31 8 15 78
Number of communities screened for trichiasis 5 (21%) 25 (81%) 8 (100%) 14 (93%) 54 (69%)
Estimated adult population of at risk communities (ABS) 1280 1860 269 721 4130
Adults examined (% of estimated population at risk) 64 (5%) 1383 (74%) 377 (140%) 305 (42%) 2129 (52%)
With trichiasis (% of adults examined) 0 (0%) 12 (1%) 0 (0%) 10 (3%) 22 (1%)
Offered ophthalmic consultation 0 12 0 10 22
Surgery in past 12 months 0 6 0 3 9
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Table 4.4 Health promotion activities in Western Australia in 2012

* 2 -4 times per year

† 5-12 times per year

Goldfields Kimberley Midwest Pilbara Total
Number of communities at-risk 24 31 8 15 78
Number of communities who reported health promotion activities 20 31 8 14 73
Methods of Health Promotion
One-on-one discussion 0 0% 5 6% 0 0% 33 47% 38 14%
Presentation to group 0 0% 44 49% 0 0% 6 9% 50 19%
Interactive group session 37 40% 13 15% 12 100% 12 17% 74 28%
Social Marketing 11 12% 1 1% 0 0% 0% 12 5%
Print material 36 39% 21 24% 0 0% 6 9% 63 24%
Mass Media 0 0% 4 4% 0 0% 6 9% 10 4%
Sporting/community events 0 0% 0 0% 0 0% 7 10% 7 3%
Other 8 9% 1 1% 0 0% 0 0% 9 3%
Total number of programs 92 89 12 70 263
Target audience
Health professionals/staff 0 0% 2 2% 0 0% 5 7% 7 3%
Children 47 51% 43 48% 6 50% 14 20% 110 42%
Youth 0 0% 0 0% 0 0% 0 0% 0 0%
Teachers/childcare/preschool staff 27 29% 18 20% 6 50% 8 11% 59 22%
Caregivers/parents 0 0% 0 0% 0 0% 9 13% 9 3%
Community members 10 11% 10 11% 0 0% 20 29% 40 15%
Community educators/health promoters 8 9% 16 18% 0 0% 8 11% 32 12%
Interagency members 0 0% 0 0% 0 0% 6 9% 6 2%
Frequency of health promotion activities
Once 8 9% 12 13% 0 0% 0 0% 20 8%
Occasional* 57 62% 74 83% 12 100% 40 57% 183 70%
Regular† 10 11% 2 2% 0 0% 22 31% 34 13%
Ongoing/routine 17 18% 1 1% 0 0% 8 11% 26 10%
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